This project started as a cross-cultural exploration of the way severe mental distress is defined and treated. After interviewing close to 20 different psychologist and psychiatrist, we have found some emerging alternatives for mental health recovery.

Open DialogueMost recently we learned of a mental health program in Northern Finland that had an extremely high rate of recovery for patients with severe mental disorders.  Their program used a technique they began 25 years ago called Open Dialogue.  The approach, described on, “de-emphasizes the use of drugs and focuses instead on developing a social network of family and helpers and involving the patient in all treatment decisions. Ongoing research shows that over 80% of those treated with the approach return to work and over 75% show no residual signs of psychosis.” While researching this we found that there were actually a few small programs here in the U.S. that were using some of the methods developed in Finland.


Dr. Daniel Fisher

One of the most successful is an organization called The National Empowerment Center, NEC which is led mostly by ‘people with lived experience’.  The current Executive Director, Daniel Fisher, was diagnosed with schizophrenia in his mid-twenties.  Once he recovered he went on to raise a family, get a Ph.D. in psychiatry and run a program that believes deeply in the possibility of recovery.  One of NEC’s programs is called Emotional CPR which is designed to teach family and friends how to engage and communicate more effectively with a loved one experiencing an emotional crisis.

Someone told me that, “Making a documentary is like chasing a wild animal. You never know where it is going to lead you.” When I met the Nechung Oracle in 1994, I had no idea that 20 years later the experience would lead me here.

Thupten Ngodrup,the State Oracle of Tibet.

Thupten Ngodrup, the Nechung Oracle.

We are planning to go to Los Angeles in a few weeks to interview Dr. Fisher and see for ourselves what happens in an eCPR training.

Do any of you know of other organizations that are having success using an ‘Open Dialogue’ approach to recovery from severe mental disorders?

7 Responses to “Open Dialogue: Alternative Approach for Mental Health Recovery”

  1. Sandra Steingard

    You might want to check in wiht Mary Olson at the Institute for Dialogic Practice in Hadlye, MA and Advocates in Framingham.MA. The Parachute NYC program is integrating these principles into a large publicly funded program in NYC. I would check them out as well.

  2. Michael Kelly


    Congratulations on this project. I am thrilled to see the array of voices that are being included in the discussion. FYI – New Hampshire has eight non-profit mental health peer support agencies which provide an array of services and supports including but not limited to WRAP, warm line and crisis respite services. At the core of this peer run system is Intentional Peer Support. I will include a link for IPS, The Copeland Center (WRAP) and several of the peer support agencies in NH. Below is a quote I lifted from the IPS website which you might find interesting.

    “As peer support in mental health proliferates, we must be mindful of our intention: social change. It is not about developing more effective services, but rather about creating dialogues that have influence on all of our understandings, conversations, and relationships.” – Shery Mead, Founder of IPS


    • Phil Borges

      Thank you for sharing Michael! I will research the links you shared. Do you work with one of the peer support agencies in New Hampshire?

  3. Uri Talmor

    Hello Phil. Wonderful project. Can’t wait to see the movie.

    Curious if you are familiar with the concept of Spiritual Emergency/Emergence (Stanislav Grof is one of the main people in that field). I’m a Transpersonal psychotherapist and it’s part of our training (my graduate program was at Naropa University in Boulder, Colorado). I use an approach I developed facilitating inner-dialogue, and my clients are encouraged to dialogue with the various energies they experience, and/or entities/ and/or physical sensation, and/or emotional sensations, etc. Whatever is going on inside seems to have it’s own consciousness (and that’s a common mystical concept, that all energy has consciousness). Almost every time, as long as the client is relating to what they are dialoguing with with curiosity/openness (which can be challenging if what they are experiencing is scary, but that’s where my guidance comes in), the dialogue can have a healing, integrative effect. And there have been several approaches that do similar work (Jung’s Active Imagination, Roberto Assagioli’s Spiritual Synthesis, and Richard Schwartz’s Internal Family System). I’ve used this approach to help people with catatonic states, delusions, and all forms of hallucinations. What I’ve found is when people can interact with their experience consciously, with some guidance, these more severe symptoms can be avoided altogether. Would be happy to share more if you like.

    Also, you may be interested in Sean Blackwell’s youtube channel bipolarorwakingup. He is also a Transpersonal practitioner, and although we seem to work with our clients with somewhat different approaches (and somewhat similar), I very much agree with the framework he lays out in his videos.

    Also, there’s a section from a Jane Robert’s book on Schizophrenia I think is brilliant. The book is called ‘Dreams Evolution and Value Fulfillment. vol 2’ and you’d be interested in pages 384-407.

    Finally, I think you would find Dr. Modi’s book Remarkable Healings very interesting. I’ve incorporated a lot of it into my inner-dialogue work. This work is common in some Christian traditions and they call it Spiritual Warfare. Modi believes that all severe mental illnesses are linked to the kind of issues she describes in this book (past life experiences, negative entities, birth trauma, soul fragmentation, etc.).

    Hope this is helpful, feel free to contact me if you have any questions, and good luck completing the project.


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